Adolescent Idiopathic scoliosis (AIS) is a multi-factorial, three-dimensional deformity of the spine and trunk which appears and sometimes progresses during any of the rapid periods of growth in apparently healthy children.
Severe spinal deformities can greatly reduce pulmonary and cardiac functions which may lead to death from cardiopulmonary failure. Therefore, surgery is generally suggested when the curvature of the spine is greater than 45-50 degrees. Non-surgery treatment, such as immobilization with a spinal cast or brace, has been and remained an important treatment modality for adolescent patients that have moderate scoliosis with a curve of 20-45 degrees to prevent curve progression and reduce deformity. Nevertheless, if the curve is less than 20 degrees, even if the child is at a high risk of progressive spinal deformity during the age of 10-16 at puberty, treatment is nothing more than just observation.
Apart from the aforesaid, the adverse psychological impact of spinal casts or braces on patients and its poor compliance has been a well-recognized problem in the field. It is suggested that these spinal casts or braces must be worn for up to 23 hours per day until the child has completed growth (for probably 4-6 years) to be effective. Due to discomfort, activity limitations and unacceptable appearance of the brace, only a small number of teenage patients fully comply with the treatment, and thus adversely affect its effectiveness and progression.